Paracetamol and Ibuprofen have comparable efficacy for immediate postpartum analgesia and they can be considered as a non-opioid substitute for postpartum pain control, suggested a recent study published in the American Journal of Obstetrics & Gynecology.

Opioids have increased concerns about their passing through breastfeeding and possible side effects. Shai Ram and researchers conducted a randomized controlled trial to distinguish between the analgesic efficacy of Paracetamol and Ibuprofen during the immediate postnatal phase.

This study included women who underwent vaginal delivery, excluding those with cesarean section history, drug sensitivity, preeclampsia, gestational diabetes, depression, chronic pain, or fibromyalgia. Included women agreed to participate after giving informed consent. Upon request for pain relief during their hospital stay, participants were randomly allocated therapy in a double-blind fashion using prepared envelopes, which contained either Ibuprofen 400 mg or Paracetamol 1000 mg. Numeric Rating Scale (NRS) was used to report pain after treatment (T0), 1 (T1), 4 (T4), and 6 hours (T6). The study documented the site of the most severe pain and the requirement for more analgesia. Additionally, it assessed how pain management influenced initiation of breastfeeding, mobility and micturition.

No differences in demographics and perinatal outcomes were noted between the groups. There were no notable variances in the time from delivery to the request for pain relief across the groups. Similar NRS pain scores were observed between the Paracetamol and Ibuprofen groups. The differences observed in initiation of breastfeeding, mobility, micturition or the requisite for extra analgesia among Paracetamol and Ibuprofen groups were also insignificant.